Rants of a Patient Safety Advocate

A recent study reports that medical errors are now the 3rd leading cause of death in the US. These statistics can change if the patient, and their family know what to do to help avoid medical injury.

This blog represents my experiences and my opinion only - often at the bedside. All posts are short enough for easy reading - therefore I couldn't possibly share all there is to share. Thank you for visiting.

Ilene Corina
Learn more at www.icorina.com

Thursday, March 15, 2018

As Patient Safety Awareness Week closes for another year, I
want to share some insight.This week
was also the one-month anniversary of the tragic Florida shootings that led to
the death of 17 people.High school
students around the country walked out of classes to remember the dead but also
protest for better gun control laws.I’m
not going to share my opinion about gun control.That’s not what I do.

I have seen patient safety activists / advocates like myself
bring up the subject again about demonstrating and marching for patient safety and
patients right.That’s what I want to
address.

I am all for demonstrations. As a matter of fact, in the
late 90’s I organized some and led some.I did so with a common theme that we all wanted information about our doctor’s
backgrounds made public.Legislation was
pending that would make it a law for doctor’s information to be made
public.What school they went to, the year
they became licensed, their practice information and their discipline record.We moved forward and the legislation was
finally passed in October 2000 but there was still concern that a doctor can
have 10 lawsuits pending and discipline action pending and until it was “proven”
we still need to be vigilant in our choosing our doctors.Physician profiles was a tool, it was not a
guarantee and we, as patients still needed and need to be cautious.

In the late 90’s we had a specific goal.Educate the public on the lack of information
available about your doctor and call or write your legislator to pass this
legislation.For me, it was never about
a “good” or “bad” doctor.It was about
my right to have information to make an educated choice – as educated as possible.

Now, come back to modern day and the interest in protesting
or marching.What would the march be
about? Patients - Rights?NY State has
22 patient’s rights.How many patients
know what they are?If you don’t, look it
up on the Internet and make sure you know what they are.

Today there are hundreds and maybe thousands of people like
myself who wish to demonstrate – make themselves heard, make their pain known
about the loss of a loved one.But what
is the final outcome?Some people
believe hand washing and preventing infections is top priority.What about our right to see medical records,
medication safety or even disclosing medical errors.Some people want accountability – does that mean
punishment for one human being accidentally harming another?What about the car accident where my
insurance compensates someone I might injure?Could I / you be the one who accidentally causes harm to another?

Do you really want to see a nurse who has worked hard her
whole adult life to save lives be punished for a mistake? The pharmacists who mixes up medication or
the doctor who tried to get the diagnosis correct but missed the mark?

Try to find a lawyer to take a case of the 90 - year old who
was misdiagnosed or the baby with a serious birth defect given a lethal dose of
medication and dies.We know how hard it is to find lawyers.Maybe we should protest that lawyers should
take all cases?An elderly patient that doesn’t
have her call bell answered and gets up and falls - or stays in a urine-soaked
bed that leaves horrid infection?

We, as a society need to stop thinking the people who work
in health care taking all the responsibility. We as a society of patients, family
members and friends MUST start taking more responsibility by speaking up,
writing letters to hospital leadership of what you see and making sure we are
all part of the solution.

Saturday, March 10, 2018

"Happy” Patient Safety Awareness Week

and though I use
the word “happy” loosely, I am happy that we are talking about patient safety. –
well at least some of us are. We have a
long way to go and I will share with you my humble opinion on what that should,
could or would look like if the patient and their family had a voice. I will
even tell you how we should get there.

1.Patient
safety MUST be brought into middle and high schools

Children must be taught what they should
be talking to their doctor about and what an appropriate exam is. If the young women from the Olympic gymnastics
team knew what to expect at an exam, they may have been more empowered to tell
someone that they were being molested.

Make Patient Involvement part of the
health curriculum

2.There must be patient support or
facilitated discussions for people who use the healthcare system. Specifically, for underserved and minority
groups. African American women are dying
from complications at child birth at alarming rates. People who are transgender often avoid seeking
care because of uneducated healthcare professionals and young mothers living in
shelters don’t always understand how to prepare for their visit or their child’s
medical appointment or know what an emergency might look like.

3.Classes for family advocates can be
offered in adult education, churches and community groups to be surethe family can understand patient safety
and be helpful to their loved ones needs.
Navigating the healthcare system is difficult during a crisis whether it’s
about safety, billing or discharge, without proper preparation the burden falls
on medical staff who are often overworked and unaware of a patient or their
family’s full needs.

Pulse Family Centered Patient Advocacy
Training covers much of the items addressed.

4.Policies need to be developed that during patient
discharge at a hospital, staff must explain pain medication addiction and
dependency. As a
bedside advocate for the past 10 years with over 1,000 hours at the bedside I
have never heard or seen the discussion about pain medication and the
relationship to addiction and dependency (including in March 2018)

While states are focused on rehab and
pharmacy / physician accountability, the discussion needs to start before the
prescription is given. This can also be
done with the Pulse Dedicated Medication Manager (DMM)

5.Although there is health literacy and communication training
for healthcare professionals, there should be for the public. We keep hearing that there is a problem with
Opioids but do people (young or old) know what they are? If a patient is sent home with Vicodin, Codeine
or Oxycodone, they may not see the risk.
Do patients understand what an MRI is or the difference between a
nursing home, rehab or assisted living?

A person to be hospitalized might learn
ahead through nonprofit support organizations how to explain in
their own words what they understand and don’t.
If they think they know what the doctor is talking about, they may not understand the importance of repeating it back

This is my short list.
If you agree and want to see these changes made please share this message
with others. Pulse CPSEA has been doing
all the above for years. I hope we can
spread this work by inviting nonprofit organizations to the 2018 Patient SafetyEducation Symposium for an afternoon of learning on May 4, 2018. Participants will then be invited to apply
for a grant to help their organization educate members or the community they
serve!

Tuesday, January 23, 2018

By high school age, children
should be prepared to visit their doctor alone.They need to share information that they may not want their parents or
another adult to hear.This should be a
relationship of trust where a young person can be treated with respect and
dignity, can ask hard questions and disclose the most difficult concerns:depression, sex, drugs etc.

Yet we live in a society where
we too often hear “No medical professional wakes up in the morning wanting to
harm their patients.” Obviously with the recent story of Dr. Larry Nassar
molesting as many as 125 young girls, it is not true that we can always trust
our clinician.

Child abuse by medical
professionals is not common, thank goodness, but it does happen. That’s just
one reason why Pulse Center for Patient Safety Education & Advocacy goes
into high schools and encourages young people to open up about their experiences
and talk with each other about their patient/clinician relationships.

“I had an early encounter with
t­wo sisters who called their doctor ‘creepy’ during a teen discussion about medical
care and preparing to see their doctor,” explains Ilene Corina, a patient
safety advocate and educator for Pulse CPSEA.“This experience disclosed problems in the relationship and I started
teaching patient safety to young people with the support and guidance of qualified
medical professionals.”

Other topics Pulse CPSEA
addresses with classes as early as middle school are preparing for the doctor’s
visit with questions; appropriately and fully explaining symptoms for the best
diagnosis; and medication safety. The presentation is fun and interactive and
leaves classes recognizing the importance of becoming “Informed and Involved” patients.

Sunday, January 7, 2018

The woman on the phone sounded
very upset. She said I was referred to
her by a person I would rather not name but it was a prominent political figure’s
staff member. I assumed now that this
would not be easy because if it were, the other person would have handled it
and not referred this person to me.

The woman was calling about
the care her mother was receiving in a local hospital. I let her speak for about 10 minutes and when
she took a breath, I said “you must be very angry over the care your mother is
receiving.” “Of course I am” she
continued for another 5 minutes.

Her elderly mother was alone
in New York while the daughter on the phone was sick and also elderly in a
state far away. I couldn’t blame her for the anger and frustration she must be
feeling. She explained that her mother has
an infection and they refused giving her antibiotics. She explained how much pain her mother is in
and how she was not being cared for. Over
a period of three days of on-going phone calls which consisted of her telling
me about her lack of finances her being black and nurses who don’t like “black
people” her mother being alone and so far away, the long list of names of administrators,
doctors and nurses she spoke to already and her mother’s dementia amongst other
subjects, I finally had to ask “How can I help?” She snapped back with “I don’t know, I was
told to call you because this is what you do”.

I decided to go visit her
mother. I was well prepared for a
serious concern of what I might find and my mind went in circles of how I
would handle it. Upon entering her
mother’s room, I noticed a small woman with her hair done in braids and a clean
nightgown and clean bedding. I checked
her armband to be sure I had the correct person and asked her, her name. The woman in the bed just stared at me. I told her I was there to see how she was and
her daughter was concerned. She smiled.

The nurses aid came in and I
introduced myself as a friend of her daughters and was just checking in. I asked who does her hair in a braid so
lovely on top of her head. The nurses
aid said they all take turns caring for her.
They seemed to genuinely like this patient. The nurses aid, a black woman said she just
ate. Yet there was no food on her face, her covers and she was clean. I asked
about her infection and was told it is better.
I asked about antibiotics and was told she finished them. The woman in the bed still wouldn’t talk so I
scrubbed down a chair for myself and asked if I can sit with her. She said “of course” with a smile. We both laughed at the TV show she watched
and at each commercial we talked a bit. She
said she was not in pain but didn’t know the plans for her future.

As a patient “safety” advocate my role is to
be sure the patient isn’t in danger.Of
course I can’t guarantee the moment I left she wouldn’t be given the wrong
medication or she wouldn’t try to get up and fall.I did get to look for things like, was the
nurse easily accessible and was the aid attentive.Was the patient in clean sheets, well kept and
was there antibacterial gel available and were the dispensers full. Did they
wash before approaching the patient, were the floors clean and did they talk to
the patient – and the patient next to her.Most importantly, if this was my family member, would I be OK leaving
her there.If the answer is “yes” I can
leave.I left.

I called the daughter to
report to her what I found. I explained to the daughter that she is speaking so loud it’s hard to talk with her
(she was yelling).

Still the daughter was
not happy with my report so we were able to move the conversation to the guilt
she is feeling being so far away.

Friday, December 15, 2017

Another
medical conference on the topic of patient safety has just passed. There have
been numerous conferences over the years, and I have attended many of them. I usually leave inspired, excited and often
overwhelmed by the upbeat and positive work being done in patient safety.

The
usual program for such conferences has patient safety leaders talking about the
wonderful work they are doing. One or
more patients, who may or may not be medical professionals, talk about the
tragedy that brought them there that day. There will be presentations about the
heartbreaking journeys of the family members of patients who died, patients who
weren’t treated well, and many presentations offering insights for the
healthcare professionals on how improvements can be made. Then there may be
awards for the great work being done to save lives.

While
all this is happening, in a state far, far away, there is another side to this.
A hospitalized patient is getting an incorrect diagnosis or the wrong medication,
or is fighting a hospital-acquired infection. Have the healthcare professionals
attending the conference remembered to tell their patient and those patients’
loved ones what they too should know about keeping safe?

I
have said for years that patient safety should be seen as like wearing a seat
belt. It is up to the driver (the medical team) to do the right thing, but if
something goes wrong we (the patients) still should be wearing a seatbelt. Not
because we are predicting something will
go wrong, but because it might. Patients
who know nothing about patient safety have no “seatbelt” are completely
unprepared for the risks and unwanted outcomes.

These
conferences need to be attended by representatives of business and industry —
both management and rank-and-file employees — that is, the people who actually use
the healthcare system.

UPS
has 434,000 employees

General
Electric has more than 300,000 employees

Bank
of America has 208,000 employees

Disney
World has 62,000 employees

In
2006 a survey found that 14.5% of employees took
Family Medical Leave in 2004. Of those, 35 percent took it more than once
during the year. How many of these days off could have been avoided if there
were fewer complications in healthcare?

Since
between 200,000 and 400,000 people die each year from preventable medical
errors, at a cost of as much as $19.5 billion[1], shouldn’t the corporate
leaders of UPS, GE, Bank of America, Disney World and other major employers be
sending their staff to patient safety conferences?

At
what point does someone in healthcare say: “We’ve had enough training but it’s
still not perfect. So now we must
include patients, their families and their employers in this conversation.

Welcome

My thoughts and comments on this blog do not necessarily represent those of any organization I am affiliated with. This is a place I can share freely what I know and learn about access to safe, quality care. Please feel free to share your thoughts also.